Posted
by
timothyon Sunday December 30, 2012 @08:46PM
from the than-a-bottle-in-front-of-me dept.

kkleiner writes "A small handful of doctors in China are using a highly controversial procedure to rid people of drug addiction by destroying a part of patients' brains. The procedure involves drilling small holes into the skulls of patients and inserting long electrodes that destroy a part of the brain called the nucleus accumbens. This area, often referred to as the "pleasure center" of the brain, is the major nucleus of the brain's reward circuit. Is it worth being cured of addiction if, losing the addiction, we also lose part of who we are?" The practice has been officially banned, but apparently continues nonetheless.

They did work out well in the past. It's easy to call treatments of the past barbaric without perspective. Often those treated with labotomies would have spent the rest of their lives in strait jackets or worse if not for the treatment. If your drug addiction is going to kill you in the next 6 months is this treatment really that terrible? Granted, governments always take this sort of thing too far "he's addicted to MMOs!" etc...

Perspective? Lobotomy began with extremely careful scraping of the brain, meant to do the absolute minimum damage possible. Then some greedy quack in the USA took it to a ridiculous extreme, turning a nice young lady into a wheelchair-bound mess because her stuck-up family was worried about their social standing, and that soon degenerated into a procedure that should have been called a crime against humanity:

They did work out well in the past. It's easy to call treatments of the past barbaric without perspective.

Not to mention the basic ideas of lobotomy are very much alive, I knew a guy with very severe epilepsy attacks. I think the surgery he had was something like this:

Multiple subpial transaction

This is used when it's not possible to remove the part of the brain that's causing the seizures. The surgeon will make a series of cuts to help separate the damaged part of the brain from the surrounding area. This stops seizures from moving from one part of the brain to other parts of the brain.

He was in his 30s and that enabled him to finally move out of his parent's house, get a bit of education and a driver's license. It didn't come without downsides but overall he was much, much better off than before.

Well, in this case, the patient is just doing it to themselves depending on the situation.

What I understand about meth and brain chemistry is that over time a meth addict is saturating the pleasure center of their brain. The structures that pick up the neurotransmitters actually become damaged or less effective over time.

This is why a lot of meth addicts will say the only way they can feel happiness is with the drug. Recovered meth addicts often complain that they have very serious issues feeling happy anymore.

How long that takes to heal, I dunno.

The end result of disabling the pleasure center may be inevitable. At least doing it in the beginning may be a way to get them stop completely and literally save their lives and increase the overall quality from a health standpoint alone. They may become emotionless, but can still live otherwise.

Just my two cents. I'm not a doctor. Just know some very unfortunate recovered drug addicts that have more in common with Vulcans now than humans.

Most of the West, the U.S. included, was big on this kind of "experimentation" (i.e. lobotomies as a kind of medical treatment) a few decades ago. No need for Hitler here.

On a positive note, much of our current knowledge of how the human brain works comes from destruction of various kinds, either from intentional and misguided treatment or from strokes. The side effects are often interesting.

The worst thing about this is that it is totally uneccesary. There was a study in the '60s that showed that targeted therapy in combination with psychedelic drugs can cure addiction with a very high success rate (compared to other methods) and almost no side effects. After lsd was made illegal research stopped but recently people have continued the program with ibogaine [ibogaine.desk.nl]. The research is still far too preliminary for conclusive results but the fact that a potential treatment exists makes brain surgery even more inadvisable.

Moderators, please mod him up as informative. Here is the take away paragraph.

Early data suggests that a period of approximately two years of intermittent treatments may be required to attain the goal of long-term abstinence from narcotics and stimulants for many patients. The majority of patients treated with Ibogaine remain free from chemical dependence for a period of three to six months after a single dose. Approximately ten percent of patients treated with Ibogaine remain free of chemical dependence for two or more years from a single treatment and an equal percentage return to drug use within two weeks after treatment. Multiple administrations of Ibogaine over a period of time are generally more effective in extending periods of abstinence. It is noteworthy that twenty-nine of the thirty-five patients successfully treated with Ibogaine had numerous unsuccessful experiences with other treatment modalities.

Moderators, please mod him up as informative. Here is the take away paragraph.

Early data suggests that a period of approximately two years of intermittent treatments may be required to attain the goal of long-term abstinence from narcotics and stimulants for many patients. The majority of patients treated with Ibogaine remain free from chemical dependence for a period of three to six months after a single dose...

Sorry, I do have points, but... No can do, on the upmod. If you spend some time on any of the sites that are genuinely run by and for addicts and ex-addicts, you will find many, many personal stories posted by sometimes desperate addicts who have actually tried ibogaine therapy. The basic message seems to be, no, it does not work, with actual results that are a far cry from the way the drug has sometimes been portrayed in the media and in the few very limited and suspect studies done to date. Ibogaine is in

"Well I believe the puppet on the left shares MY beliefs, well I believe the puppet on the right has MY interests at heart...hey wait a minute, there is one guy controlling both puppets!"...Bill Hicks. The man has been gone more than 20 years and its even more true now than it was back then.

I urge all of those who think "If only my party got control things would be better" to watch the truth about voting [youtube.com] and ask yourself some simple questions like : How many decades have been people voting for less government intrusion? less war? Less handing out billions to third world thugs? hell how many years have we been complaining and voting about the horribly broken borders? the corruption? the influence of lobbyists?

At the end of the day you can NEVER change a corrupt system by working within that system, why? Well the answer is obvious, its corrupt! That would be like handing a petition to some corrupt police force demanding they stop taking bribes...why would they care what you think? Like pro wrestling its all kayfabe and thanks to the revolving door between the corps and government today's senator will be tomorrow's lobbyist so by voting him out all you are doing is giving him a pay raise while letting someone else get a shot at the money!

Is it worth it to cure addiction if you utterly destroy everything that makes life worth living?

How could any rational person think this is a good idea?

Well, if the purpose is to punish the sinner and terrorize the potential sinners, then irreversible zombification certainly works better than mere prison sentences, and is thus rational. After all, it's not like locking up pot smokers is intended to help them, but to destroy their lives as thoroughly as possible.

Can't find it offhand, but there was an interesting TED talk a while back by a fellow who had received repeated ECT treatments. I forget the details, but the gist was that he had been a respected professor until he suffered a mental illness that sent his life spiraling into oblivion. When all the less radical treatments failed, ECT managed to fix the problem and he was able to rebuild his life. No argument that there have been some horrible abuses in the past, but it does seem that there are situations where it is in fact the best option available. As with *any* neurological treatment though, I think the consent of the patient is absolutely crucial - forcibly altering someone's mind without their consent seems to me to be about the worst form of rape imaginable.

It's almost exclusively used for major major MAJOR depression that's totally unresponsive to every other treatment - you certainly aren't healthy, but you're oriented in the spheres of person, place and time when you give your informed consent. It's probably a reverse cause though; I think (and Wiki agrees) it has shown some effectiveness in psychosis and schizophrenia but when you're loony like that you can't give consent so they can't zap you...it isn't the 50s anymore.

Oh, that's scary what Cameron did, especially considering that "he had been a member of the Nuremberg medical tribunal in 1946â"47." Seems like the counterpoint to "those who forget the past are doomed to repeat it." It's more like he took the Nazi's inhumane human experimentation as inspiration for his kooky and secretly carried out experiments (the patients did not know they were being experimented upon) rather than as a warning of the level of depravity that can be reached by man's inhumanity to m

This is possibly the single worst thing that the Nazis did. They turned the world away from eugenics, because they were so cold hearted and calloused toward an entire race.

In and of itself, eugenics is a good thing. I would love to see it advanced. The research could lead to the cures for cancer, diabetes, heart disease, possibly even make our entire race stronger and smarter. The possibilities are endless.

But, because eugenics were so horrible abused by one group of people, against another group of people, we refuse to even look down that road.

I don't suppose that science will advance on that frontier unless and until a significant portion of mankind has left mother earth. I just hope that by then, the researchers haven't forgotten the atrocities committed by the nazis. The memories must be preserved, or mankind risks repeating those same atrocities.

Everywhere there was an eugenics program, it was abused For all of the potential benefits, it seems that as a species we just can't seem to find an ethical path through eugenics, so we need to leave it alone until we can handle it. Hitler just showed us the extremes of what was happening elsewhere already.

Granted, it was abused. But, most other abuses were far less horrifying than what the Nazis did. Some of the abuses in the US were pretty bad, but they could have, and should have, been addressed, fixed, and allowed to advance. Without the catalytic effect of the Nazi's programs, I'm half sure that is what would have happened.

But if you think about this it's actually a pretty lousy argument. It makes your conception the most important fact in history. Think how many other IFs you could justify just to make yourself happen. 'If your mother hadn't been raped, you wouldn't have happened. If your father hadn't had one of his balls shot off you wouldn't have happened. If Hitler hadn't existed your parents wouldn't have met. If Nagasaki hadn't been bombed the celebration of the end of the war would have been a day later so you wouldn't have happened,.......' Once you start thinking like that EVERYTHING that happened becomes a good thing, since it resulted in the miracle of YOU. So why not look at it without such selfish thought. If your parents filtered out that gene, they would have had the child without that gene. That's it.

Actually I'd say they learned from the Japs, after all the Japs made the crazy Austrian look like a humanitarian when it came to human experiments. The worst part is unlike the Nazis we let most of the monsters left in Japan walk to get their data whereas with the Nazis we mainly went after the eggheads making rockets and jet engines, not the guys doing human testing.

as for TFA we tried that kind of stuff before, it was called a lobotomy, made the symptoms go away alright and left a broken doll in place of a human being. We are talking about obliterating the pleasure center of the brain so they will NEVER feel pleasure again, i bet a good 70%+ end up committing suicide in 5 years or less. Hell it would be more humane to just take them out back and treat them with a 45cal to the back of the head.

Would he have wanted to live if he never found any joy in living ever again?

Speaking for myself (who doesn't have a drug addition), hell yes.

Sure it's a reduced quality of life from ideal, but it's still life. Besides, there's a reason it's referred to as the "pleasure centre" and not the pleasure centre, the brain isn't that neatly divided, I'm sure they can still feel some kind of pleasure, and have other forms of satisfaction in life, but that particular reward mechanism won't function (at least not in the same way).

Never being able to feel satisfied again? Who the hell would want to live like that? Jesus. At least I was only circumcised so that I'd only feel pain from just my genitals and never pleasure. If my whole world were that way... christ, the things people like you would wish on other people is frightening.

How much moralizing did your friend have to put up with that only drove him to be more addicted rather than accepting he's addicted and choosing treatment. How much stigma was associated with "being com

if you were circumcised and can't feel pleasure from your penis then something went horribly, horribly wrong with the procedure. That's definitely not normal. I'm circumcised so I know what I'm talking about.

Yes, something did go horribly wrong. Unfortunately, nobody's cared to understand non-obvious failure modes of that procedure. So, nobody thought that anything could go wrong when they decided to do it, at least not anything non-obvious that can not be corrected by further surgery. It didn't stop it from going wrong, though.

In fact, when I started estrogen HRT (I'm transgendered) I asked my doctor about it just to make sure I wasn't making some awful mistake. His theory was that it was only because it seemed that my brain was female, and he postulated that a female brain might not, to put it in slashdot speak, have the proper device driver for it all to work right. Unfortunately, nobody told my doctor that what happened to me is possible. I'm not even sure I'm faulting circumcision correctly, but what I do know is what I feel, that I'm circumcised, that problem is with the same body part involved in that, and that no other trans person I've met can corroborate my experience. (I would likely still be transgendered and seek estrogen HRT even intact--I believe that because there are intact trans women and I can't figure out what difference it would make anyway in that matter.)

What do I do about it, though? I guess I have to wait until they can grow me a new one from stem cells and replace it. I'm SOL in the meantime. Fortunately, I found other ways to satisfy myself, so all's not lost. I just may never be successful in giving my parents grandchildren.

I'm comparing this to circumcision to hopefully make readers think. Some may agree with circumcision but disagree with this brain surgery and vice-versa.

I only meant to raise the question of what can possibly go wrong and is it worth it to risk the occasional disaster when something less invasive and traumatic, like relaxed drug laws and treatment, might solve the problem just as well or even better.

Did you have a botched circumcision, or did you willfully have your penis removed as part of a surgical transformation into a vagina?

I don't mean to seem callous, but I am amazed the AMA allows doctors to mutilate people, even if they feel like they really need to be mutilated. IMHO there is a huge difference between a male circumcision and a sex change operation gone wrong...

Undoing some moderation, but wanted to chime in. I'm also a trans woman, and circumcised. As far as I can tell, my penis always worked fine. (Where 'fine' = 'got erect, ejaculated, functioned well enough for me to deposit sperm.') So far as I can tell, my being trans is unrelated to how well my genitalia does or doesn't function. Let me know if this responds to what you were curious about - I'd be happy to chat more.

In civil law, this is true. But there is no statute of limitation on especially heinous crimes or where there's continuous violations.

It should be rather obvious that performing alterations like this should only be allowed with informed consent, not just in parentis but actual legal consent. This is 2012 (2013 by the time some of you read this) and not the dark ages where we do acts because we should not question the invisible bearded man and his followers, whether their frock is black or white.

Would he have been better served to still be here w/o some "reward center". I don't know. I will never know.

I read somewhere within the past month that the traditional/popular notion of a pleasure center is not correct. According to whatever I was reading, it's more of an impulse/addiction center, and the pleasure/reward comes from several other parts of the brain working together.

The argument was something along the line that people or apes would repeat actions that stimulate the center, but it doesn't actually cause any pleasure.

Losing a friend because he made bad decisions is tragic, and cause for grief. Having a friend lobotomized because the government has decided youre making bad decisions is horrifying, and cause for outrage.

There is a big difference between making bad decisions freely, and having the government decide that you are no longer fit to make your own decisions.

Losing a friend because he made bad decisions is tragic, and cause for grief. Having a friend lobotomized because the government has decided youre making bad decisions is horrifying, and cause for outrage.

There is a big difference between making bad decisions freely, and having the government decide that you are no longer fit to make your own decisions.

There is a grey area here Mr Black'n'White, and that's when your bad decisions hurt and kill other people. And I mean directly, not just like 'you shouldn't smoke because someone else will have to take care of you later on' and 'the hospital couldn't save your mother because they were busy dealing with an overdose', I mean because ice addicts are killing people in their violent rampages and other addicts are robbing people to feed their next hit. That's when it becomes the governments problem.

And the whole definition of addition is that you are no longer fit to make your own decisions because your addiction is making them for you.

I'm not quite sure lobotomy is the answer here, but it may turn out to be the best of the available options.

I wonder if it's possible to just turn off that part of brain for a bit instead of destroying it...

I mean because ice addicts are killing people in their violent rampages

Citation needed.

and other addicts are robbing people to feed their next hit. That's when it becomes the governments problem.

...which is a consequence of prohibition, which drives up prices, and not of the drug itself. How many alcoholics do you see robbing people to feed their next hit? Addicts committing theft is a government-created problem.

And suggesting that the government has the rightful power to forcibly and irreversibly modify

Ice (4-Methylaminorex) was not present for really long on the black market as it tended to kills users quite quickly, you must me talking about meth or mdpv but even those do not make peoples go berserk unless they stay up for more than a week.

Mostly I was talking about the ACs, but let's talk about you. What BoRegardless said was:

Now [my drug-addicted friend] is gone. Would he have been better served to still be here w/o some "reward center". I don't know. I will never know.

This is not a statement of support. It is a statement of confused grief.

After misinterpreting this as fervent support, you proceeded to speculate wildly about BoRegardless's motivations and his late friend's addiction, levy criticism based on that speculation, and recommend that he read a story about being trapped in a hellish existence where death is the only escape.

In response to a person who just said that his friend had died. Yesterday.

The article is talking about a surgery that is performed only in China, only for research purposes, and only with worldwide condemnation. The only debate outside of China is whether the results of that research should be published in respectable journals.

Your comment did not address that debate. It will have zero effect on what happens in China. The only thing it does is attack and belittle someone who just lost a friend. In your zeal to put on a show of righteousness on the internet, you are stepping all over the real human being who is (metaphorically) right in front of you.

When it comes to a real problem a change in personality wouldn't be such a problem, but losing dopamine forever? Never to feel positive emptions again ever? I don't care who you are that's not worth it. Surely the reason people get addicted to begin with is they don't have enough dopamine and serotonin in their life for whatever reason.

I've heard that drug/alcohol abusers are all 'self-medicating' themselves, unknowingly trying to do what proper medication can achieve. We know so much more of how the brain works today, when properly diagnosed, and in conjunction with recovery programs, the odds of getting a normal life back are far higher than what they used to be. To paraphrase a Dr. McCoy quote, "Drilling holes in peoples heads is not the answer."

The story sucks, but I have to wonder. We do some radical brain surgeries at times just to fix problems with seizures. At least in the long term addiction carries a higher incidental rate of death, lowered quality of life, and such than seizures.

So I guess I'd have to say 'it depends'. I'd view it a bit the same as stomach stapling for weight loss -

I'd need to know a heck of a lot more about the details of the surgery - primary effects, dangers, side effects, success rates, etc...Does it result in an unmotivated zombie, because there's no longer any reward for doing so much as life maintenance tasks? Can they still feel pleasure? Is it only being used on the most serious 'mental' addiction cases? I added mental because this wouldn't solve physical addictions to things like heroin, I think, but might help solve addictions to gambling, stealing, etc...

Going by the article, it seems to only stop addictions 10% better than traditional methods, and is still well under half. 60% have serious side effects, so I'm going to go with 'nope, not worth it, keep looking'.

As for 'losing who you are', well, even just day to day life you change. I'm not the same person I was a decade ago. Technically I'm not the person I was yesterday. If somebody wants to change, it might be worth it.

Agreed, but because I think it's the completely wrong approach and that it completely ignores the root cause. It's like using circumcision to treat urinary tract infections. There are plenty less-traumatic and less-invasive ways of achieving the goal. At least there may be a way to undo a stomach staple that I haven't cared to learn about. If things go horribly wrong after that piece of brain is flushed down a garbage disposal, how do you ever get it back? Or is suicide the option left for whoever you

It probably isn't appropriate to bring circumcision into this thread, because brain surgeries like this are a whole world more revolting and horrific.

I think I agree. Circumcision surgery is both less talked about and not nearly invasive enough for a comparison in my head. At least a stomach stapling requires cutting you open, and deals a bit with 'addiction'(to food in this case) and behavior modification(you can no longer eat the same as you did before with a stapled stomach). But I also look at it in the case of other brain surgeries - stopping seizures, for example. So I look at an example of brain surgeries, and and example of behavior modificat

For example, Michael J Fox had an ablative procedure (thalamotomy) to treat his parkinson's disease. We don't really do that procedure anymore because deep brain stimulation has gotten better, but this article is extremely light on details and the write up (particularly by the OP) is needlessly sensationalized.

This is like treating your kid who bites their nails by having their nails surgically removed. It doesn't address the WHY of addiction, it simply removes one aspect of it. I'd wager that people who are cured of their addiction by this method are also cured of things like pleasure, joy, motivation, etc.

But I'm sure America will adopt it soon enough. We're more interested in punishing people for drugs than treating the cause behind those drugs.

Are the pleasures a drug-affected brain feels to be equated with other forms of pleasure?

It would be one thing to wipe-out part of a healthy brain (thereby permanently altering it) like this but it might be another matter to make such a permanent change to a brain that has already had permanent, and negative, changes made by "modern chemistry". Of course, the presence of any pre-existing damage from drugs also raises questions of true consent. Not sure how I feel on this one, but given that this is on brains already affected by drugs the morals and ethics are a bit cloudier than they might otherwise be. Personally, I find the idea of depriving a person of the ability to experience pleasure both creepy and dangerous. Should we expect future headlines about "zombie" violence in China?

Which drugs are we talking about here? Some drugs, like meth, are "modern chemistry." Other drugs, like opium, alcohol, caffeine, weed, shrooms, etc, etc are as old as the hills.

For that matter, who are we to judge what form of pleasure somebody may experience or not? It also calls into question the term "addicted." What constitutes addiction, and when do we determine "addiction" is bad? SSRI-class drugs are highly addictive; I know that firsthand from quitting. They tell me sex is addictive, but I'm on slashdot so I wouldn't know lol. Cheesecake can be addictive, and so can caffeine.

Are we performing this horrific procedure on people simply because our own lives are miserable and we don't like that somebody found a way to be happy? Or is this a person who is unable to support themselves? Would this person be able to support themselves if not for whatever habit we want to correct by completely annihilating their ability to feel pleasure of any kind?

I agree with your conclusion. Creepy and dangerous.

Yes, this surgery is creepy and dangerous.

However, when you veer off into talking about addiction in general, you start conflating two very different phenomena: dependency and addiction. Dependency is the fact that if you stop using the substance in question, you will experience adverse effects. Stop drinking caffeine after you've become dependent, and you'll experience headaches. Etc. Addiction is a primary neurological disorder stemming from the way the reward/pleasure centers of the brain are wired. Add

Dr. John Adler, professor emeritus of neurosurgery at Stanford University, collaborated with the Chinese researchers on the publication and is listed as a co-author. While he does not advocate the surgery and did not perform it, he believes it can provide valuable information about how the nucleus accumbens works, and how best to attempt to manipulate it. “I do think it’s worth learning from,” he says. ” As far as I’m concerned, ablation of the nucleus accumbens makes no sense for anyone. There’s a very high complication rate. [But] reporting it doesn’t mean endorsing it. While we should have legitimate ethical concerns about anything like this, it is a bigger travesty to put our heads in the sand and not be willing to publish it,” he says. cite [time.com].

From the time I was 12 until the time I was 48, I spent most of every day thinking about sex, and wanting it desperately, and sometimes even getting it. Then one day my sex drive...faded. I couldn't get it up any more, I couldn't get it off any more, and underneath all that, I didn't care about it so much any more. That incessant, gnawing hunger was gone.

I miss it terribly.

I've been to my doctors, and they've poked and prodded, and run this test and that test, and prescribed this pill and that pill, and wit

The functioning is certainly altered, since that "skin" contains the most sexually sensitive parts of the penis. Also, phimosis is irrelevant -- it is a rare condition that can be treated without such amputation anyway.

Actually, circumcision does cause serious functional damage -- since it reduces man's capacity for sexual pleasure, you can say it is ultimately very similar to that Chinese brain surgery. Also, it is connected to over a hundred deaths every year.

Is it worth being cured of addiction if, losing the addiction, we also lose part of who we are?

If the part that's lost is the scabby, rot-mouth tweaker who steals power tools to pawn for $20 to get that next hit, sounds good to me. It hardly sounds like this procedure is so precise, tho. Like trimming fingernails with a chainsaw. And the success rate is just shy of 50% in their very limited study. I'd want high 90s before I'd consider letting some Dr. Nick stick wires in my brain.

Fortunately, my only addiction is tasty food and that's socially acceptable in America.